Boat Insurance Quote February 16, 2016by JWDavis Boat Insurance Step 1 of 7 14% Owner’s Name:* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Telephone Number:*Your Email* When should coverage start:* Date Format: YYYY slash MM slash DD Do you belong to a Canadian Yachting Association:YesNo Manufacturer and Model of Vessel:Year*Manufacturer and Model*Purchase Date* Date Format: YYYY slash MM slash DD Length*Boat HIN#Tender HIN#Aux Motor Serial #Vessel Type:* Sail Motor Multi-Hull Other If Other, please describe:Method of propulsion:* Outboard Inboard/Outboard Inboard Jet Fishing Utility Bass Boats Fishing Runabouts Other – Describe: Runabout Utility Bowrider Closed-Deck Runabouts Ski Boat Performance/Sport Boat House Boat Midcabin Cruiser Motor Yacht Deck Boat Hull Material:* Wood Aluminum Fiberglass Other If Other, please describe:Metallic Flake Finish:*Please selectYesNoEngine Make*Year:*Total Horsepower:*Maximum Top Speed:*Fuel:*Please selectGassolineDieselPropaneOtherPurchase Price:*Current Market (Resale) Value:*Replacement Value:* Equipment: From the following list check the appropriate equipment which is installed in the vessel or portable in nature but used specifically in the operation of the vessel and included in Hull Insurance.Trailer used: Trailer used solely for transportation of the Insured yacht: Year:Serial No.:Manufacturer:Value:Tender used: Tender used solely for transportation between the insured vessel and shore: Year:Serial No.:Manufacturer:Length:Value:Outboard Motor use: Outboard Motor used with tender, or as auxiliary Model Year:Serial No.:Manufacturer:HP:Value:RadarYesNoFathometer or Depth SounderYesNoSonarYesNoDirection FinderYesNoC.B. Radio/V.H.F.YesNoOther (Please describe):CradleYesNoBuilt-in Fire Extinguishing System?YesNoBuilt-in Fire Extinguishing System: CO2 Halon Automatic Manual Other Auto Bilge Pumps: Engine Blower Vapour/ Fume Detector Smoke Detector/Alarm Auxiliary Generator (Type of Fuel):Other (Please describe):Is Boat equipped according to Federal Coast Guard Standards?Please selectYesNoAppliance Type - Stove/BarbaqueAppliance Type - Stove/BarbaquePropaneButaneNatural gasPilot LightPlease selectYesNoIf Propane/Butane, Natural Gas is used, where is tank located?If Propane/Butane, Natural Gas is used, is vapour vented externally?Please selectYesNoAppliance Type - Furnace/HeaterAppliance Type - Furnace/HeaterCentral electricPortable CSA approvedOtherPilot LightPlease selectYesNoIf Propane/Butane, Natural Gas is used, where is tank located?If Propane/Butane, Natural Gas is used, is vapour vented externally?Please selectYesNoAppliance Type - RefrigerationAppliance Type - RefrigerationYesNo Berthing & Navigation:If you sign a “Hold Harmless” agreement with your Yacht Club or Marina you must forward a copy of this agreement to us immediately:SummerLocation:Please selectOutsideInsideMooring Berth:Please selectAshoreAfloatWinterLocation:Please selectOutsideInsideLay-up Berth:Please selectAshoreAfloatFrom: Date Format: YYYY slash MM slash DD Lay-up Coverage: Coverage contemplates a Lay-up Period from November 15th to March 31st. If lay-up period is different, please indicate.To: Date Format: YYYY dash MM dash DD Lay-up Coverage: Coverage contemplates a Lay-up Period from November 15th to March 31st. If lay-up period is different, please indicate.Is extension of Navigation Limits required?Please SelectYesNoDescribe: Pleasure used only?YesNoIf Boat corporately owned, provide specific details of usage:Is Boat used Commercially or Chartered :Please SelectYesNoDescribe:Are you chartering your yacht?Please SelectYesNoHow long have you been employed in commercial operations?What is the period during which commercial operations are carried out?What limit of liability is required?INPUT $What are the estimated annual gross receipts?INPUT $Does Applicant employ a paid crew or captain?Please SelectYesNoWhat is the passenger capacity of your vessel?Water skiing/Tubing/Knee Boarding?Please SelectYesNoRacing:Please SelectYesNoDescribe: Qualifications and experience of all operators:Name 1: First Last Date of Birth 1 Date Format: YYYY slash MM slash DD Have you previously owned a pleasurecraftPlease SelectYesNoNo. of YearsNumber of years of experience as operatorYears of experience this type of vesselName #2Name 2: First Last Date of Birth 2 Date Format: YYYY dash MM dash DD Have you previously owned a pleasurecraftYesNoNo. of YearsNumber of years of experience as operatorYears of experience this type of vesselName #3Name 3: First Last Date of Birth 3 Date Format: YYYY slash MM slash DD Have you previously owned a pleasurecraftYesNoNo. of YearsNumber of years of experience as operatorYears of experience this type of vesselName #4Name 4: First Last Date of Birth 4 Date Format: YYYY slash MM slash DD Have you previously owned a pleasurecraftYesNoNo. of YearsNumber of years of experience as operatorYears of experience this type of vesselBoat courses taken:YesNoDescribe:Loss History:Please list in detail any known and/or reported boating, property, automobile losses and/or infractions for the past five years for all operators:Please list previous Insurer:*Has insurance been refused or cancelled by any Company?Please SelectYesNo Vessel INPUT $ (A)Equipment INPUT $ (B)Total Hull $ 0.00 CAD INPUT $ (A+B)Limit of LiabilityINPUT $Limit Personal EffectsINPUT $Notes